From the Categorical to the Dimensional Approach in Psychopathology: The Case of Auditory Hallucinations

Our paper is aimed at showing that the dimensional approach, when applied to mental disorders, is more powerful and empirically-based than the categorical one, even when it concerns symptoms that seem to be restricted to psychotic people, like auditory hallucinations. We will argue that, when properly investigated, hearing voices can be present not only in very different mental disorders, but also in non-clinical individuals. Moreover, even if hallucinations are a typical symptom of psychosis, they do not cause the psychosis, and are not caused by the psychosis. This approach could explain the cognitive sciences’ difficulties in investigating auditory hallucinations, in that they try to identify a specific anomaly, a defect in some specific mechanism, which differentiates psychotic and healthy people. The aim of this paper is to show that the dimensional approach, explaining symptoms by other symptoms, may help us to reach a much more complex vision of the metacognitive, relational, and social dynamics that underlie psychotic symptoms.